There is little information about the willingness of medical students to participate in Facebook for education. I analyzed my interactions with students for the past 14 months to estimate the quantity of student interaction. A Facebook Group was created. Students friend requests were accepted, but “friending” was never solicited. Questions were created around a clinical situation and posted. Forty questions were posted. 5/40 questions were about physics/chemistry. 24 questions focused on basic medical sciences. 11 questions were primarily about clinical medicine. In fourteen months, 533/810 (66%) college students joined the Group. In all, 163/533 students (30%) responded at least once. Half of all responses were comments; the rest were clicks on the “like” button. The average number of responses was 9.5 unique students/question. If participation is voluntary, and targeted students are large in number, one can expect about 66% of students to become members of a site, and about 30% of these to interact. For any given question posted on the site, about 2% of members will respond, regardless of the nature of question: clinically oriented or basic.
Education, Medical ; Social Media

Objective: The natural history of asymptomatic (silent) gallstones has been inadequately studied. Existing information derives from studies based on oral cholecystography or relatively small sample sizes. We planned a retrospective cohort study in subjects with gallstones to determine conversion rates from asymptomatic to symptomatic. Methods: We extracted data from computerised databases of one government hospital and two private clinics in Malaysia. Files were scrutinised to ensure that criteria for asymptomatic gallstones were fulfilled. Patients were called on telephone, further questioned to confirm that the gallstones at detection were truly asymptomatic, and asked about symptoms that were consistent with previously defined criteria for biliary colic. Appropriate ethical clearances were taken. Results: 213 (112 males) patients fulfilled the criteria for asymptomatic gallstones and could be contacted. 23 (10.8%) developed pain after an average follow up interval of 4.02 years (range 0.1-11 years). Conversion rates from asymptomatic to symptomatic gallstones were high in the first two years of follow up, averaging 4.03±0.965 per year. Over time the conversion rates slowed, and by year 10 the annual conversion rate averaged only 1.38±0.29. Conversion rates were much higher for females compared to males (F:M hazard ratio 3.23, SE 1.54, p>z 0.014). The lifetime risks for conversion approached 6.15% for males, and 22.1% for females. Conclusion: In conclusion, asymptomatic gallstones are much more likely to convert to symptomatic in females than in males. Males in whom asymptomatic stones are discovered should be advised conservative treatment. Surgery may be preferable to conservative management if the subject is a young female.